Provider Demographics
NPI:1841833480
Name:PARAGON RETINA PLLC
Entity type:Organization
Organization Name:PARAGON RETINA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUGE
Authorized Official - Middle Name:
Authorized Official - Last Name:KESEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-719-2040
Mailing Address - Street 1:8260 GREENSBORO DR STE A20
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-4913
Mailing Address - Country:US
Mailing Address - Phone:215-287-6130
Mailing Address - Fax:
Practice Address - Street 1:8260 GREENSBORO DR STE A20
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4913
Practice Address - Country:US
Practice Address - Phone:215-287-6130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty